For the second year in a row, a state report on hospital-acquired infections in North Carolina shows Charlotte-area hospitals performed at or better than the national average, with some exceptions.

The 233-page report released Friday discloses 2013 data from 104 hospitals about five of the most common infections acquired by patients while being treated in acute-care hospitals.

A 2011 law made North Carolina one of about 30 states that mandates publication of hospital-acquired infections. This year’s report shows some progress, officials said.

“North Carolina hospitals have made tremendous efforts to protect their patients, but approximately 1 in 25 hospital patients still contracts a healthcare-associated infection each year,” said Zack Moore, medical epidemiologist with the state’s Division of Public Health.

Infections reported this year are:

• Bloodstream infections associated with central lines, or tubing, that deliver medicines, fluids or nutrition through the veins.
• Urinary tract infections associated with contamination of tubes inserted into the bladder to collect urine.
• Surgical site infections after colon surgery and abdominal hysterectomies.
• Infections caused by methicillin-resistant Staphylococcus aureus (MRSA), a bacteria that can affect the skin or bloodstream.
• Infections caused by Clostridium difficile (C.diff), which causes diarrhea and fever and has become resistant to certain antibiotics.

While the rate of MRSA infections in hospitals has been falling over the past decade, the number of C. diff infections is rising, Moore said. Collecting infection data “helps us to see where to direct our efforts,” he said.

For example, Moore said hospitals “have the most problem” with catheter-associated urinary tract infections. “Quite a few North Carolina hospitals, including Carolinas Medical Center, are significantly higher than the national baseline.”

CMC, the region’s largest hospital and part of Carolinas HealthCare System, reported a higher-than-predicted rate of catheter-associated urinary tract infections – 132 instead of the predicted 69, based on national averages. The hospital also reported higher-than-predicted numbers of surgical site infections after hysterectomies (12 instead of the predicted 6).

But CMC reported lower-than-predicted numbers of central line-associated bloodstream infections (33 instead of the predicted 69) and C. diff infections (139 instead of the predicted 216). MRSA infections were in the expected range based on the national average but higher than North Carolina hospitals overall.

“Catheter-associated urinary tract infections are particularly challenging to large, complex healthcare systems,” said Dr. Katie Passaretti, medical director for infection prevention at Carolinas HealthCare. She said the system has a comprehensive program to reduce hospital-acquired infections and will be dedicating more attention to reducing these specific infections in coming months.

Novant Health Presbyterian Medical Center, the second-largest hospital in Charlotte, also reported higher-than-predicted catheter-associated urinary tract infections (20 instead of 12). And it also had lower-than-predicted numbers of central-line-associated bloodstream infections (8 instead of the predicted 18). In other categories, Presbyterian’s infection rates were similar to the national average.

About 4 percent of all hospital admissions result in an acquired infection each year, leading to 99,000 deaths, according to the U.S. Centers for Disease Control and Prevention. The North Carolina infection report is at http://epi.publichealth.nc.gov/cd/diseases/hai.html.